Syllabus for Family Medicine Clerkship

Transcription

1 Syllabus for Family Medicine Clerkship Course No.: OM 7010 Course Title: Family Medicine Outpatient Credit Hours: 4 weeks, 4 credit hours for each rotation Pomona: Lebanon: Dat Trinh, D.O., Chair John T. Pham, D.O., Vice Chair Term - Dates: Variable in OMS III academic year Level: OMS III Department of Clinical Education Contact Information FOR POMONA CAMPUS Natalie A. Nevins, DO, MSHPE, Director of Clinical Education, Pomona nnevins@westernu.edu, (909) , Marisa Orser, M.Ed. Assistant Director of Clinical Education (909) Students contact Rotations Department staff by Submitting an OTRS ticket Preceptors can compsite@westernu.edu FOR OREGON CAMPUS Katherine Fisher, DO, Director of Clinical Education, Oregon kfisher@westernu.edu (541) Joan Paluzzi, PhD Assistant Director of Clinical Education (541) Students contact Rotations Department staff by Submitting an OTRS ticket Preceptors can nwsite@westernu.edu Educational Goal Purpose of the Rotation 1. To provide the student with a solid foundation in the diagnosis and management of common conditions encountered by Family Physicians as well as health care maintenance and disease prevention. In addition, the rotation should expose the student to the full breadth of Family Medicine so that any student specifically interested in Family Medicine will be better prepared to decide if they want to pursue post graduate training. Page 1 of 10

2 Rotation Description 2. This rotation provides exposure and experience in the clinical setting of the normal and abnormal conditions encountered by Family Physicians. Attention is devoted to the recognition and management of common problems typically seen by primary care physicians as well as conditions which may be less common with critical thinking of the problem to conclusion of treatment. Students evaluate patients in the inpatient and outpatient setting. They may perform the breadth of evaluation and management, write notes in the medical record, assist with common minor office procedures. If the Clinic or Hospital policy does not allow the student to document in the permanent record, the student is expected to write a note and orders separate from the chart and ask the preceptor to critique it. Core Family Medicine Outpatient Clerkship Learning Objectives 1. The student should be able to function effectively as a member of the health care team in a primary care setting and appreciate the roles and functions of other health care professions. (COMP/AOA core competencies 2, 3, 4, 5, 6, 7; Institutional outcomes 2, 3, 4) 2. The student should be able to present the data gathered in patient encounters in a concise summary to the preceptor; discuss each problem to consider further diagnosis and treatment plans, consultation, and dispositions. (COMP/AOA core competencies 2, 3, 4, 5; Institutional outcomes 1, 2, 3, 4) 3. The student should have knowledge of current guidelines for disease screening by age group. (COMP/AOA core competencies 2, 3, 6; Institutional outcomes 1, 2, 7) 4. The student should be able to write progress notes using appropriate format (SOAP). (COMP/AOA core competencies 2, 3, 4, 5; Institutional outcomes 1, 2) 5. The student should be able to: elicit and document a history from assigned patients recognize signs and symptoms of disease processes assess mental health status communicate empathetically with a patient perform and document a physical examination perform and interpret diagnostic tests manage, under the supervision of the preceptor, common healthcare problems provide patient education 6. understand general management guidelines for common chronic diseases(comp/aoa core competencies 1, 2, 3, 4, 5, 6, 7; Institutional outcomes 1, 2, 4, 5, 7, 8) 7. The student should be able to perform OMT when clinically appropriate. (COMP/AOA core competencies 1, 2, 3, 6; Institutional outcomes 1, 2, 8) 8. The student should be familiar with when / how to make referrals. (COMP/AOA core competencies 2, 3, 5, 6, 7; Institutional outcomes 1, 2, 3, 4) 9. The student should be familiar with universal precautions. (COMP/AOA core competencies 2, 3; Institutional outcomes 1, 2, 3, 5, 6, 7) Rotation Expectations During the rotation, the student is expected to do the following: 1. The student should be able to function effectively as a member of the health care team in a primary care setting and appreciate the roles and functions of other health care professions. The student should be able to present the data gathered in patient encounters in a concise summary Page 2 of 10

3 to the preceptor; discuss each problem to consider further diagnosis and treatment plans, consultation, and dispositions. 2. The student should have knowledge of current guidelines for disease screening by age group. 3. The student should be able to write progress notes using appropriate format (SOAP). 4. The student should be able to: elicit and document a history from assigned patients recognize signs and symptoms of disease processes assess mental health status communicate empathetically with a patient perform and document a physical examination perform and interpret diagnostic tests manage, under the supervision of the preceptor, common healthcare problems provide patient education understand general management guidelines for common chronic diseases 5. The student should be able to perform OMT when clinically appropriate. 6. The student should be familiar with when / how to make referrals. 7. The student should be familiar with universal precautions. 8. Lecture or present case histories as requested by interns, residents or attending. 10. Be timely. 11. Wear appropriate attire. 12. Be professional at all times. Required Educational Assignments Please see Blackboard ECM V Course for the following: Family Medicine Month: Assigned Readings: Online: Clinical Practice Guidelines Lifestyle Recommendations Med-U FM CASES: Case 2: 55 yo male annual exam Case 4: 19 yo female with sports injury Case 6: 57 yo female presents for diabetes care visit Case 8: 54 year old male with elevated blood pressure Case 13: 40 yo male with a persistent cough Case 15: 42 yo male with right upper quadrant pain Case 16: 68 yo male with skin lesion Case 18: 24 yo female with headaches Case 19: 39 yo male with epigastric pain Case 22: 70 yo male with new-onset unilateral weakness Case 23: 5 yo female with sore throat Case 27: 17 yo male with groin pain WISE-MD: Page 3 of 10

4 CLIPP: Skills Module: Best Practices Case Module: Skin Cancer Case 24: 2 yo with altered mental status Case 32: 5 yo girl with rash Case 28: 18 month-old with developmental delay 10 Points for attesting to completion of modules/readings. 5 Point Quiz. Case Conference/Case Presentation/Case Study Students are required to attend any case conference/presentations/study as requested by their preceptor or site. Recommended Procedure List (to see or do) Specific Objectives The student should be familiar with and / or perform and evaluate common office-based laboratory results including: All diagnostic blood work pertinent to the disease state being evaluated Urine analysis Hemoccult Wet mount Peak flow Spirometry Audiometry Glucose The student should be familiar with and / or perform the following medical / surgical procedures: Venipuncture Urine dip stick / urine pregnancy test Cerumen removal Foreign body removal Toenail removal, skin lesion removal, biopsy Sutures/staples removal Intramuscular and subcutaneous injections Immunization injections Intravenous line Irrigation and drainage Wound management Splinting, ace wrapping Laceration repair Local anesthetics Diabetic foot care Page 4 of 10

5 Catheterization Core Family Medicine Topics of Study CARDIOVASCULAR Hypertension Hyperlipidemia Cardiac Arrhythmia Myocardial Infarction (MI) RESPIRATORY Upper Respiratory Tract Infection Asthma GASTROINTESTINAL Hepatitis / Pancreatitis Irritable Bowel Syndrome Inflammatory Bowel Disease Gastritis, Peptic Ulcer Disease ENDOCRINOLOGY Diabetes Type 1 and Type 2 Thyroid Disease HEMATOLOGICAL AND ONCOLOGICAL Anemias Breast Cancer / Cervical Cancer Colon Cancer Cardiac Murmur Deep Vein Thrombosis Congestive Heart Failure Angina and Ischemic Heart Disease Lower Respiratory Tract Infection Bronchitis / Pneumonia Chronic Obstructive Pulmonary Disease Cholecystitis / Cholelithiasis Parasitic Infections Diarrhea, Vomiting, Constipation Gastroesophageal Reflux Disease Galactorrhea Vitamin B-12 Deficiency Lung Cancer Prostate Cancer GYNECOLOGICAL / GENITOURINARY Menopause, Osteoporosis Contraceptives Vaginitis Menstrual Disorder MUSCULOSKELETAL Osteoarthritis, Rheumatoid Arthritis Back and Neck Pain Carpal Tunnel Syndrome NEUROLOGICAL Headaches (tension, migraine, cluster) Seizure Disorder Hormone Replacement Therapy Sexually Transmitted Diseases Urinary Tract Infections Epididymitis / Hydrocele Sprains and Strains Gout Arthritis Injuries Cerebral Vascular Accidents Movement Disorders Page 5 of 10

6 Dementia and Alzheimer s Disease Multiple Sclerosis Bell s Palsy DERMATOLOGICAL Acne Seborrhea Warts Bacterial Skin Infection OPHTHALMOLOGICAL / OTOLARYNGOLOGY Conjunctivitis / Blephitis Allergic Rhinitis / Epistaxis Sinusitis MENTAL HEALTH Anxiety Depression Obsessive-Compulsive Disorder IMMUNIZATIONS Pediatric Immunization Tourette s Syndrome Muscular Dystrophy Increased Intracranial Pressure and Masses Fungal Infections Viral Exanthems Skin Cancer Atopic Dermatitis Corneal Abrasions, Foreign Bodies Visual Disorders Hearing Disorders Substance Abuse Suicidal Ideations Death and Dying Adult Immunization Rotation Faculty Students are assigned to specific credentialed clinical faculty/preceptors at their core clinical site. Pomona Dat Trinh, D.O., Chair Professor of Family Medicine Appointments available by at dtrinh@westernu.edu Lebanon John T. Pham, D.O. Vice Chair Assistant Professor of Family Medicine Appointments available by at jtpham@westernu.edu Texts and Media Supplemental: Kasper: Harrison s Principles of Internal Medicine Sloane: Essentials of Family Medicine Barker: Principles of Ambulatory Medicine McGraw Hill William & Wilkins William & Wilkins NOTE: Individual preceptors may include other resources. You will be notified of these resources by each preceptor. If your preceptor does not offer additional resources, ask them what resources they like to use. Page 6 of 10

7 Instructional Methods Scheduled rotation time will be used for supervised patient care, case presentations (onsite and online) and independent studying. You will be required to complete on-line modules as part of your requirement to successfully pass the rotation. Rotation Format, Evaluation, Grading, and Student Feedback Additional information is located in the Clinical Education Manual at: Rotation Schedule Each site will provide students with a schedule on their first day of the rotation. These schedules are rarely available prior to the start of the rotation. It is solely your responsibility to read and understand all information provided to you by the site. Some sites have additional requirements above and beyond those set forth by the College of Osteopathic Medicine. Evaluation/Grading Grading for your clerkship will be calculated according to the Clinical Education Manual However, completion of the rotation will also depend on completion of the ECM 5 modules that correspond to your clerkship schedule. Please note, your attending/preceptor s evaluation is based on, but not limited to the following: Communication skills regarding patients Care provided to assigned patients Attendance and participation at conferences, morning reports lectures and meetings Demonstration of library references on patients Completion and accuracy of paperwork on patients (Histories and Physicals, progress notes, treatment plans, presentations, hand-outs, etc.) Interaction with attendings, residents, students, medical staff, nursing and ancillary personnel General knowledge base and knowledge applied to specific patients Motivation in the learning process Overall performance, participation, enthusiasm to learn, and effort to improve Page 7 of 10

8 Mid-rotation grades should be given by the intern/resident/attending. The final grade should be given/reviewed with the student on the last day of the rotation. General Policies Policy on Disability Accommodations: To obtain academic accommodations for this rotation, students with disabilities should contact the Center for Disability and Health Policy (CDHP) and the rotation coordinator within ten days prior to the beginning of the rotation. Disability Services can be reached at Remediation Policy: Refer to the Clinical Education Manual at pdf. Attendance Policy: Refer to the Clinical Education Manual at pdf. Academic Dishonesty: Complete confidence in the honor and integrity of the health professions student and health care professional is essential. Such confidence depends entirely on the exemplary behavior of the individual health care provider in his or her relations with patients, faculty and colleagues. Strict honesty as a personal way of life should be nurtured during the period of education for professional service. The student shall conduct all aspects of his or her life with honor and integrity. This includes accountability to oneself and to relationships with fellow students, future colleagues, faculty, and patients who come under the student s care or contribute to his or her training and growth, and members of the general public. This applies to personal conduct that reflects on the student s honesty and integrity in both academic and non-academic settings, whether or not involving a University sponsored activity. Upon accepting admission to the University, each student subscribes to and pledges complete observance to the Standards of Academic and Professional Conduct as outlined in the University Catalog for each academic program. A violation of these standards is an abuse of the trust placed in every student and could lead to suspension or dismissal of the rotation and/or COMP. Western University of Health Sciences Institutional Learning Outcomes WU INSTITUTIONAL OUTCOMES Health Professional Education 1. Critical Thinking The graduate should be able to identify and solve problems that require the integration of multiple contexts when performing patient care. 2. Breadth and Depth of Knowledge in the Discipline/Clinical Competence 3. Interpersonal Communication Skills The graduate should be able to perform appropriate diagnostic and therapeutic skills, to apply relevant information to patient care and practice, and to educate patients regarding prevention of common health problems. The graduate should be able to effectively use interpersonal skills that enable them to establish and maintain therapeutic relationships with patients and other members of the health care team. 4. Collaboration Skills The graduate should be able to collaborate with clients and with other health professionals to develop a plan of care to achieve positive health outcomes for their patients Page 8 of 10

9 5. Ethical and Moral Decision Making Skills The graduate should be able to perform the highest quality of care, governed by ethical principles, integrity, honesty and compassion. 6. Life Long Learning The graduate should be able to engage in life-long, self-directed learning to validate continued competence in practice. 7. Evidence-Based Practice The graduate should be able to utilize research and evidence-based practice and apply relevant findings to the care of patients. 8. Humanistic Practice The graduate should be able to carry out compassionate and humanistic approaches to health care delivery when interacting with patients, clients, and their families. They should unfailingly advocate for patient needs. WesternU COMP and COMP-Northwest Program Learning Outcomes COMP/AOA CORE COMPETENCIES Competency: Osteopathic Medical Students are part of an educational continuum that leads to residency and the curriculum provides the foundation for the following outcomes: 1. Osteopathic Philosophy and Osteopathic Manipulative Medicine Graduates are expected to demonstrate and apply knowledge of accepted standards in Osteopathic Manipulative Treatment (OMT) appropriate to their specialty. The educational goal is to train a skilled and competent osteopathic practitioner who remains dedicated to life-long learning and to practice habits in osteopathic philosophy and manipulative medicine. 2. Medical Knowledge Graduates are expected to demonstrate and apply knowledge of accepted standards of clinical medicine in their respective specialty area, remain current with new developments in medicine, and participate in life-long learning activities, including research. 3. Patient Care Graduates must demonstrate the ability to effectively treat patients, provide medical care that incorporates the osteopathic philosophy, patient empathy, awareness of behavioral issues, the incorporation of preventative medicine, and health promotion. 4. Interpersonal and Communication Skills Graduates are expected to demonstrate interpersonal/communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams. 5. Professionalism Graduates are expected to uphold the Osteopathic Oath in the conduct of their professional activities that promote advocacy of patient welfare, adherence to ethical principles, and collaboration with health professionals, life-long learning, and sensitivity to a diverse patient population. Residents should be cognizant of their own physical and mental health in order to effective care for patients. 6. Practice-Based Learning and Improvement Graduates must demonstrate the ability to critically evaluate their methods of clinical practice, integrate evidence-based medicine into patient care, show an understanding of research methods, and improve patient care practices. 7. Systems-based Practice Graduates are expected to demonstrate an understanding of health care delivery systems, provide effective and qualitative patient care within the system, and practice cost-effective medicine. Page 9 of 10

10 Revised December 2014 COMPARISON OF OUTCOMES STANDARDS: WU AND COMP WU COMP Critical Thinking 1 1, 2, 3 6 Breadth and Depth of Knowledge in the Discipline/Clinical Competence 2 1, 2, 3, 4, 5, 6, 7 Interpersonal Communication Skills 3 4 Collaboration Skills 4 4 Ethical and Moral Decision Making Skills 5 1, 3,5,6 Life Long Learning 6 1, 2, 3, 6, 7 Evidence-Based Practice 7 1, 2, 3, 6, 7 Humanistic Practice 8 3, 4, 5 Copyright Statement: Copies of documents used in this rotation were made available under Section 107 of the Copyright Act of 1976, the Fair Use Statute. This material has been made available solely for use in this class and the material may not be further distributed to any person outside the class, whether by copying or by transmission in electronic or paper form. If Fair Use does not apply, copyright permission to reproduce these documents has been applied for or granted through the Copyright Clearance Center or the copyright owner. Page 10 of 10